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Must Eyes Be Dry To Feel Dry? * (The Tragic Consequences of Entrenched Conventional Wisdom)

If past is epilogue, making sense of dry eye disease (DED) will remain a distant hope for the foreseeable future.  Considering the vast intellectual and financial resources that have been invested in the continuing search for clarity in our understanding of this disorder, one would imagine that the seemingly intractable enigmas posed by the tear-centered... Read More »

Are Unexplained Chronic Dry Eye Symptoms Caused By Insufficient Tears? Rev.2

The word “Dry” in ‘dry eye disease’ reflects conventional wisdom that dry eye-like symptoms are caused by a deficiency of tears, either in amount or quality. This model is based on valid observations; these eyes typically feel dry as defined by symptoms exacerbated in high evaporative environments, diminished in humid, still air and mitigated by instilling artificial tears and improving Meibomian gland function. Nevertheless, despite these observations, the traditional tear deficiency model is seriously flawed: It cannot explain the poor correlation between intensity of symptoms and tear metrics or the state of the Meibomian glands.

Patients as Teachers

Long-standing Corneal Neuropathic Pain Following LASIK A 44 y.o. male reported the rapid onset of progressively disabling corneal pain and photoallodynia 5 years following LASIK that had persisted for 3 years at the time of our initial examination. Except for typical LASIK scars, external examinations of his eyes were normal as were his tear metrics.... Read More »